In preparing for closing arguments in the state of Oklahoma’s case against drug companies it accuses of creating a deadly opioid abuse and addiction epidemic, attorney Michael Burrage said he thought to bring a copy of an old book with him to court.

The book, “All I Really Need to Know I Learned in Kindergarten” by Robert Fulghum, advises that people should learn early on and always remember to clean up their own messes. Burrage said Johnson & Johnson and Janssen Pharmaceuticals, defendants in the trial that has played out over the past month and a half in Cleveland County, made a huge mess in Oklahoma and across the nation beginning in the 1990s, and now they should be made to clean it up.

Burrage, along with other attorneys representing the state, Brad Beckworth, Reggie Whitten and Oklahoma Attorney General Mike Hunter, offered closing statements that lasted about two hours. They said the state presented witnesses and offered evidence through the course of the trial that proved J&J and its subsidiary were driven simply by greed to sell far more opioid-based pain medications than the state or nation needed. Hunter described a “cunning, cynical, deceitful scheme” to oversupply drugs like Oxycontin, Hydrocodone, Vicodin, Lortab, and later on Nucynta and Duragesic, and to influence patients to ask for the drugs and doctors to prescribe them. Thousands of Oklahomans have died as a result of accidental overdoses, he said, families have been destroyed and the “public nuisance” inflicted on the state will cost upwards of $17.5 billion and 30 years of work to abate.

“The only question is whether the Oklahoma taxpayers or the kingpin (J&J) should be required to bear its costs,” Hunter said.

In his closing statement, which also lasted for about two hours, J&J attorney Larry Ottaway countered that drug problems in Oklahoma and across the country have many different and complex causes and can’t be blamed on Johnson & Johnson or other drug companies.

“This is not a problem with a simple answer,” he said.

Ottaway said it is undeniable that opioid-based pain medications are legitimately prescribed by doctors and taken daily by many Americans. According to the U.S. Centers for Disease Control, 50 million adults in the United States are afflicted by chronic pain. The attorney recounted statements made by doctors called to testify in the trial that people who don’t find relief from such pain commonly lose their jobs, families and all quality of life, which often leads to depression and suicide.

“Every aspect of your life is negatively impacted when you have chronic pain,” Ottaway said. “This problem of people with chronic pain afflicts Oklahoma.”

Ottaway defended J&J and Janssen as innovative companies that developed products responsibly, putting extra time and effort into making medications as tamper-resistant and thus as difficult to abuse as possible. He said the drugs have always carried “black box” warnings of potential side-effects and other dangers as mandated by the federal Food and Drug Administration, and that the FDA monitored and regulated all activities of J&J and its subsidiaries. He reminded Judge Thad Balkman, who presided over the non-jury trial, of testimony of a statistician who reviewed massive electronic databases of insurance records to determine that the defendant drug companies have never held more than a tiny share of the overall opioid market in Oklahoma.

“The state would have you believe we marshaled an army to come to Oklahoma and fool Oklahoma doctors about the risks and benefits of opioids. Not true,” Ottaway said. “These are tough, tough, decisions to treat patients in pain with opioids, to balance access against risk. They are not easy answers. They are only easy for lawyers. They are only easy for people who don’t have to deal with chronic pain.”

In his closing statement, attorney Beckworth reminded the judge about why the state has labeled J&J the “kingpin” in the opioid crisis. The mammoth, international corporation decades ago bought subsidiary companies Tasmanian Alkaloids and Noramco that were major suppliers of raw poppy and raw ingredients used in the production of opioids by numerous companies, Beckworth said. Two of those companies, Purdue Pharma and Teva Pharmaceuticals, admitted no wrongdoing but earlier settled with Oklahoma for $270 million and $85 million respectively. Beckworth said aggressive “unbranded marketing” and efforts of pharmaceutical sales representatives were meant not just to sell specific drugs, but opioids in general. Only after the epidemic and its staggering costs became a national news story did J&J decide to divest itself of the opioid supply companies.

“They took the money and ran and left us here holding the body bags,” the attorney said.

Beckworth also recalled testimony about hundreds of thousands of “call notes” made by Janssen sales reps related to visits paid to doctors in Oklahoma. Despite claims made by some doctors that they weren’t influenced, the attorney repeatedly referred to a graphic introduced into evidence that indicated rising numbers of sales calls made on Oklahoma doctors, rising numbers of prescriptions for opioids written and rising numbers of overdose deaths, with the lines on the chart nearly matching one another.

Burrage also referred to the graphic as he insisted that “something happened,” beginning in the mid-1990s to cause opioid abuse to skyrocket in the state.

“In 1996 we had bad doctors, we had addicts, we had drugs, we had all those elements already. So what changed? What changed in 1996 to cause the addiction rate, the death rate to skyrocket?” Burrage asked. “Aggressive, fraudulent marketing by J&J and others, but the kingpin is sitting right there at that (defense) table.”

Ottaway rejected that idea. He said testimony and evidence presented in the trial clearly showed that drug abuse of all kinds and associated deaths were rising in Oklahoma and across the country well before the 1990s and that they have tracked consistently upward since.

“Oklahoma and America, unfortunately, have a drug problem. I wish we could snap our fingers and cure it. Unfortunately, we cannot,” Ottaway said.

During his portion of the state’s closing statement, Whitten recalled testimony of a number of witnesses tragically affected by opioids, including several who said they had never tried or had any interest in illicit drugs but who got hooked on opioids after suffering some injury. He showed a short film clip of Austin Box, a former standout football player at the University of Oklahoma, celebrating after a big win. Box died of an accidental opioid overdose days after graduating.

“If you believe, as (Oklahoma Department of Mental Health and Substance Abuse Services) Commissioner (Terri) White and other experts have testified, that it will take a minimum of 30 years (to clean up the mess), there’s the number: $17.5 billion,” Whitten said. “They (J&J) did this. They made tens of billions of dollars off this. It’s demonstrably unfair for them to complain about (the abatement costs) now.”

Oklahoma’s was the first trial in the nation held to determine whether the pharmaceutical industry should be held accountable for widespread opioid abuse, addiction and overdose deaths. Some 2,000 similar lawsuits have been filed against drugmakers and distributors by states, cities and tribes across the country.

Judge Balkman said he has asked attorneys representing both sides in the case to submit some additional “findings of fact” no later than July 31. He congratulated both sides for their preparation and professional conduct. According to Bob Burke, who served as special master for media and public access during the trial, the judge may consider evidence for as long as a month before rendering his judgment.

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Please share this with Terri White! She is my hero after her amazing testimony in the Johnson & Johnson case. To see her stand up and do battle against that giant was one of the most courageous and admirable moments I have ever witnessed. You see my son has battled addiction for years. As parents, my husband and I were going up against Johnson & Johnson trying to fight a battle with addiction that I fully believe they created in order to make money. Our meager income was nothing compared to the money J & J gained by creating this disaster. Yet my husband sold his vacation back to his employer for cash 3 years in a row, we cashed in retirement stock, we spent our savings trying to help our son battle his addiction and keep him alive. He is alive and sober today and we are blessed to have him so. However our lives are changed and we will never recover what Johnson & Johnson and their partners took from us. From one very grateful mother, “Thank you Terri White, you are my hero!”